Category Archives: Ankles

Starting them young! My time with Upper Dublin High School

I had a great experience last week when my friend Megan Gallagher invited me to speak about podiatry to students at Upper Dublin High School.
I’ve been blessed to have alot of experience with public speaking from QVC to podiatry conferences, but from some reason, I was very nervous about speaking to a group of 16-18 year olds.
I thought about when I was 18 years old at Archbishop Wood High School and the last thing I wanted to do was look at people’s feet all day! How would I deliver a message to myself at 18 that would hit home. Why did I become a podiatrist?
It was simple: To Help People.
I told the students my background, about medical school, my residency, a couple showstopper stories (maggots and other unique experiences) but I decided to pushed the “why” of our profession.  (I love this TED talk in the link)
Podiatrists have the ability of preventing and treating problems that can be life changing. Most patients will see their podiatrist more often than any other doctor because of their periodic appointments. It is at these appointments that we may either treat a problem or direct them to the proper physician.
You know doc, I’ve been dizzy” or “You know doc, I’ve been falling alot.” These passing statements need to be acted on to prevent worse issue.
So when I was talking to the students, I explained to them that it is not always about the feet, but in my practice, it’s about treating the PERSON.
If anyone has been my patient, I joke that sometimes their appointments are more like a SOCIAL HOUR than a doctor’s appointment. It’s that friendly approach that allows my patients to be comfortable, open up and discuss their lives.
So remember students, Podiatry is a specialty that focuses on care of the feet, but more importantly, it’s about the care of the PERSON.

Barking Dogs Podiatry Family Business
Have a problem, give us a call and set up an appointment!
484.681.9485 or visit us at

75 Degrees and Sunny: What a great day for the Broad Street Run!

Hope everyone had a great day yesterday at the Broad Street Run! The weather couldn’t have been better and Broad Street was full of supporters.

This is still one of my favorite races and looking forward to running it again.

Thanks to all the Barking Dogs Supporters who wore our shirts to  the race!!!!


Broad Street Run Slefie

Broad Street Run

Broad Street Run

SEPTA Train to The Start Bravery


Broad Street Run Post Race

Speed Demon!!!

La Salle University’s Toniann Cummins (Razzi)

Broad Street Barking Dogs

Braod Street Run Pre Race Looking Good in the Orange


Fantasy Football Owners Beware!!! The Dreaded High Ankle Sprain Will Wreck Your Season!!

As I retired from competitive sports, I have settled into my second sports life as a fantasy owner.  I’m horrible at it. I’m poor at drafting and I don’t make good weekly decisions with a common occurrence of having my top performer on the bench.  I’ve noticed one injury though that can wreck a season: THE HIGH ANKLE SPRAIN.

In professional sports we often see ankle sprains occur in play and the athlete bounces back quickly.  Sometime, they return to the field during the same game.   With the high ankle sprain, though, you may find your top player on the bench for weeks.  With a short fantasy season (14 weeks on average), this could be the difference between playoffs and Dr. Pagano status (basement).

What are the differences between a high ankle sprain and a normal ankle sprain? 

In a typical ankle sprain, the ligaments that support the ankle can suffer tearing and even rupture, leaving the ankle joint unstable.  This can happen from trauma or simply taking a bad step.  There are 3 grades of ankle sprains,  Grade I being the mildest (strain on the ligaments) and grade III being the worst (rupture of the ligaments).  The injury can be very painful. Recovery involves PRICE (protection, ice, compression and elevation).  After a period of recovery, therapy is utilized to retrain the ankle and supports may need to be worn.  If conservative care fails, surgical intervention may be required to repair. 

The high ankle ligaments are above joint itself.   These ligaments hold the tibia and fibula together. When walking and running, the stability is necessary for function.  If there is weakness or damage here, every step spreads the tibia and fibula and can be excruciatingly painful.  While not as common as the ankle sprains, the damage requires a longer recovery time with possibility of surgical intervention as well. Regular recovery from a high ankle sprain can be as long as 6 months to a year.

So as I scream about the Darren McFadden’s of last year, hoping that he will start this week, I’ve learned my lesson.  Roddy White’s injury has me searching the waiver wire each week for a replacement. Ugh, it’s gonna be another long year, full of fantasy mistakes.

So should I move in on Randall Cobb and Colin Kaepernick for Drew Brees, my receivers are a joke and I’m in last place?




I Can’t Get Cancer in my Feet…Right, Dr. P?

My Irish descent has given me many wonderful qualities: a great sense of humor, a positive outlook on life, and a happy demeanor. I’ve also hit the jackpot with pasty white, SPF 50 required, porcelain skin. Skin cancer runs in my family so close monitoring is essential to prevent problems. Because the issue is close to my heart, as a podiatrist, I am always on the lookout for skin cancers. It may seem hard to believe, but you CAN get cancer on your feet. It is often difficult to diagnose because a problem can be hard to see or feel.

Skin cancers are often painless but reoccurring cuts or wounds. Sometimes they appear as a freckle, a mole, or bruising in an area where no injury occurred.


This was a bruise that wouldn’t go away.

What should you look for?

Examine any unusual area using the acronym, ”ABC:” Asymmetry, Border and Color. Asymmetry means the abnormal area is not even or symmetrical in shape. The border may be irregular, lacking smooth rounded edges. It may be raised or be even with the surrounding skin. The color of the area lacks consistency; meaning it may have many different colors within the lesion. Finally, the size of the abnormal area/lesion is important. I get concerned when a lesion is bigger than 5 mm. Early detection can SAVE YOUR LIFE.

At Barking Dogs Foot and Ankle Care, we take the time to examine the skin on your feet AND lower legs. If something is suspicious, a simple in-office test can aid in early diagnosis. There is no mole too small, no freckle to light, and no concern too silly. As the saying goes, “an ounce of prevention is worth a pound of cure.” With the summer around the corner and the Jersey shore calling your name, be sure to protect yourself with appropriate skin coverage and DON’T FORGET ABOUT YOUR FEET! To make an appointment with Dr. Pagano, DPM, contact us at 484.681.9485 or visit our website at

Ryan Howard’s Achilles and how a phanatic podiatrist deals with frustration

Ugh. Another year my beloved Phillies bowed out of the postseason early. But this year was different:  Howard swung.  He exploded out of the box to beat out a groundball and ended up exploding his Achilles Tendon.

Howard Achilles Injury

Next Year is our year

The Achilles tendon is the strongest and thickest of all the tendons in the body. It’s function is to lift the foot/heel off the ground when running and walking.  A rupture of the tendon may occur after abrupt calf muscle contraction.  This occurs more frequently in males over the age of 30 who sporadically engage in sports.  My weekend warriors:  beware!

There may be an audible pop, and the injured warrior may feel like they were struck in the leg.  In a complete rupture, you would not be able to stand on your toes, let alone walk.

So when should you consider surgery?  Surgery has a 68% reduction in re-rupture when compared to non-surgical treatment.  There is also a quicker recovery especially when followed by physical therapy and rehab.  With a healthy patient that is active and able to tolerate the surgery, repair is usually the optimal treatment.

Our slugger underwent surgical repair and is recovering. Unfortunately, it will be  long time of recovery and rehab (4-6 months) and although it breaks my bleeding red heart, he may not return to his previous level. But! I choose to take the positive Zen-like outlook. Plus, I refuse to root for any other team.

How can you prevent an Achilles tendon rupture?  Be prepared for the sports you play. Be sure to stretch appropriately prior to activity and warm up well.  Don’t just jump in,  forget your high school glory days and play within your means.

The new update is that Ryan had an infection cleared out of the surgical area. This is a common complication with ANY surgery and fortunately for our slugger, the infection is cleared and he is on antibiotics.  Be patient everyone. While I got excited hearing about Howard blasting home runs in bp the past week, this is gonna be a process.  Let’s face it friends:  We need Howard in October.  I promise you he will be rocking and rolling then!